NPI | 1154734176 |
---|---|
Former Name | KAITLYN E CHILDERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-32329) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12734-24) |
225100000X Physical Therapist (Licence: OR 63178) | |
Enumeration Date | 2014-06-06 |
Last Update Date | 2025-04-24 |